help

hi i would like some advice on my sons changed behavior hi is 4 amd just about to start school but he has just started pooing himself about four times aa day,the stools are not loose .he has had no lifestyle changes or anything different. it has been the last 8 weeks or so he has been doing this ,could there be something wrong with his bowels.
i have not yet told him off for this as maybe it is not his fault any advise would be great
thanks.

[Rebecca Resnik, PsyD]

Hello,
   it is not unusual (though certainly not pleasant) for little kids who have mastered potty training to have periods of regression. Since he has mastered it in the past, you know that he is capable of controlling his bowels in general. Now, the first stop should be to the pediatrician. Keep a record of a few days that describes when he soils and the consistency of the stool. This is important because if your son is withholding stool or constipated, he could be avoiding voiding because it has become painful. Once kids start withholding, the stool becomes hard and difficult to pass, which in turn leads them to withhold further to avoid discomfort. Over time, stool can become impacted, with loose stool leaking around the hard stool (a condition called encopresis).  If your son is having this problem, the pediatrician will help you with dietary changes and  medication as appropriate.

For many children, going to school is a huge change; more than enough to interfere with their toileting. Many children become so distracted in school that they ignore the urge to go. He may also not feel comfortable going at school. The body must relax in order to void, and if he feels nervous for any reason he may have trouble (common reasons might not having enough time to go, fearing the loud flush, discomfort with an unfamiliar toilet, feeling pressure from teachers etc.). These reasons might seem silly to us, but they are very significant to a little child, and must be taken seriously if he is to overcome them.

I definitely would not punish or criticize him for accidents, as you are most likely to make the whole situation worse. Offer positive reinforcement (stickers, small candies, lots of hugs and praise) and make sure he sits on the potty after meals for at least 10 min (after meals is the best time as the digestive system is activated by eating). Ask the teachers to please put him on the potty every hour without scolding or pressuring him. With lots of gentle encouragement, he is likely to get back on track in a few weeks. Just remember that this is a normal early childhood issue, and be patient with him. I have no doubt that he is eager to regain control if for not other reason than to please you.

Best Wishes
Rebecca Resnik

Disclaimer: The information in this post is for informational purposes only. It is not intended to replace face-to-face medical or psychological treatment. This post is not intended to create or imply a patient-clinician relationship. It is also not intended to provide nor to rule-out a diagnosis.